# Steven D. Wexner

Steven D. Wexner is an American surgeon and physician. He is Director of the Ellen Leifer Shulman and Steven Shulman Digestive Disease Center at Cleveland Clinic Florida. Wexner has received numerous regional, national, and international research awards. Through his multiple academic appointments, Wexner personally trains 15-20 surgeons each year, and he educates thousands more around the world through conferences and lectures. He is a resource for his colleagues from around the world for referral of patients with challenging or complex problems. In 2020, he was elected vice-chair of the Board of Regents of the American College of Surgeons for a one-year term. Since 1990. he has served as Symposium Director of the Cleveland Clinic Annual International Colorectal Disease Symposium. The Symposium was held in Fort Lauderdale or Boca Raton every year from 1990 to 2019. Since 2020, the Symposium has expanded to include host locations outside of the US with interruptions during the pandemic years of 2021–2022.

## Education

Wexner received his bachelor's degree from Columbia University in 1978. He earned his MD in 1982 from Weill Cornell Medicine. He completed a general surgery residency in 1987 at Roosevelt Hospital (now Mount Sinai West). In 1988 he completed a fellowship in colon and rectal surgery at the University of Minnesota Medical School in Minneapolis, MN.

## Career

In 1993, Wexner was named chairman of the Department of Colorectal Surgery at Cleveland Clinic Florida. While at Cleveland Clinic he also served as Chairman of the Division of Research and Education from 1996 to 2007, as well as Chief of Staff from 1997 to 2007. He served as Chief Academic Officer from 2007 to 2012. In 2012 He was appointed the Director of the Digestive Diseases Center.
Wexner holds academic appointments as affiliate professor at Florida Atlantic University; clinical professor at Florida International University; affiliate professor of surgery at the University of South Florida, Tampa, Florida; clinical professor of surgery at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; affiliate professor of surgery at the University of Miami Miller School of Medicine; professor of surgery, University of Siena, Siena, Italy; visiting professor, Faculty of Medicine, the Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel; and visiting professor at the University of Belgrade in Serbia.
As a founder of the National Accreditation Program for Rectal Cancer (NAPRC). he led a multi-faceted coalition to establish the accreditation program with the American College of Surgeon's Commission on Cancer. The NAPRC's goal is to implement nationwide educational and medical standards for the best treatment of rectal cancer.

## Innovation and research

In 2022, Cleveland Clinic Florida received a $5 million gift to fund Wexner's research. In recognition of their generous contribution, Cleveland Clinic Weston recognized the Shulmans by naming the Digestive Disease Center the Ellen Leifer Shulman and Steven Shulman Digestive Disease Center.
In an interview with Local 10, Wexner shared that he has been seeing a higher frequency of colorectal cancer in younger patients, due to genetic drift as well as environmental and dietary factors. This is often misdiagnosed until the disease has become advanced, and so Wexner recommends beginning regular colonoscopy screenings earlier than guidelines currently advise.

### J-pouch procedures

Much of Wexner's work has been focused on improving surgical techniques for the avoidance of permanent stomas in patients with colorectal cancer, ulcerative colitis, and fecal incontinence. He introduced a popular modification to the technique for creating an ileo-anal pouch, or j-pouch for ulcerative colitis, in which double stapling is used in place of sutures to improve results. He also popularized the colonic j-pouch for patients with rectal cancer. The J-pouch, an alternative to a permanent ileostomy or colostomy, allows patients who have had their colons removed to continue to have regular bowel movements without an ostomy bag. This is now the standard of care for patients with rectal carcinoma across the country and world.

### Incontinence and constipation scores

The Wexner Incontinence Score is the most common score used to determine the severity of incontinence before and after surgery for anal incontinence. The Wexner Incontinence Score is based on the research of Wexner and his associate J. Marcio N. Jorge, MD. The scoring system takes into account the frequency of incontinence, alterations a patient makes to cope with incontinence, and lifestyle modifications.
Wexner's research has also developed the Wexner Constipation Score, occasionally known as the Cleveland Clinic Constipation Score.$^{[7]}$ The score measures the severity of constipation by taking into consideration a number of factors, which his research found to correlate with objective physiologic findings. Information on these factors is collected from each patient's subjective reports, and they are given a score. This score allows for appropriate and consistent diagnosis and treatment. The factors include the frequency and completeness of bowel movements, the difficulty of evacuation, the type of assistance used (if any), the patient's level of pain, and duration of constipation.
In 1996, Wexner and colleagues released a method of scoring perianal disease activity for patients with Crohn's Disease. The goal of the scoring system is to utilize a patient's medical history and the results of physical examination to predict the likelihood of success of surgical intervention. Prior to the development of this method, doctors lacked reliable indices of disease activity or prognostic implications from surgery.

### Patents

* US patent 20090281560A1, Wexner, Steven D. & Regadas, Francisco Sergio Pinheiro, "Method for anastomosis surgery using zip-ties", published 2009-11-12
* WO patent 2010030707A1, Regadas, Francisco Sergio Pinheiro & Wexner, Steven D., "Surgical string applicator for anastomosis surgery and method of use", published 2010-03-18
* US patent 7954251B2, Wexner, Steven D.; Nunes, Rogean R. & Regadas, Francisco Sergio Pinheiro, "Multifunctional airway evaluator for orotracheal intubation", published 2011-06-07
* US patent 7954251B2, Wexner, Steven D.; Nunes, Rogean R. & Regadas, Francisco Sergio Pinheiro, "Multifunctional airway evaluator for orotracheal intubation", published 2012-03-06
* US patent 8211129B2, Regadas, Francisco Sergio Pinheiro & Wexner, Steven D., "Method for anastomosis surgery using zip-ties", published 2012-07-03
* US patent D682425S1, Wexner, Steven D.; Nunes, Rogean R. & Regadas, Francisco Sergio Pinheiro, "Airway evaluator for orotracheal intubation", published 2013-05-14
* US patent 9526502B2, Regadas, Francisco Sergio Pinheiro & Wexner, Steven D., "Surgical string applicator for anastomosis surgery", published 2016-12-27
* US patent 20170056020A1, Regadas, Francisco Sergio Pinheiro & Wexner, Steven D., "Surgical string applicator for anastomosis surgery and method of use", published 2017-03-02

## Honors and awards

In 1999, Wexner was awarded an FRCS from the Royal College of Surgeons in Edinburgh, Scotland. In 2000 he was awarded an FRCS ad eundum from the Royal College of Surgeons in England. In 2008 he was elected to the Royal College of Surgeons of England by a unanimous vote of its council. This is the highest distinction conferred by the council. In 2015, Wexner was awarded honorary membership in the European Surgical Association and the European Society of Coloproctology.
In 2013, Wexner was awarded an honorary foreign membership in the Argentina Society of Coloproctology. In 2012, Wexner was awarded the degree of PhD honoris causa by the University of Belgrade. In 2003, The American Jewish Committee presented Wexner with the prestigious Maimonides Award. In 2013, he was awarded Professor Emeritus of I.M. Sechenov First Moscow State Medical University. In 2016, Wexner was recognized by Cleveland Clinic Florida as a Master Clinician.
In 2017, Wexner was awarded an honorary membership into the Society of General Surgery of Peru, honorary fellowship in the Royal College of Surgeons in Ireland, and Honorary Clinical Senior Lecturer at the University College London. In 2019, Wexner was awarded an Honorary Fellowship by the Royal College of Physicians and Surgeons of Glasgow, Scotland. Wexner was elected as an Honorary Fellow of the Royal College of Surgeons of England in 2022.
In 2022, Wexner was appointed as a visiting professor in the Department of Surgery and Cancer at Imperial College London and Honorary Consultant at Imperial College Healthcare NHS Trust.

## Professional memberships and positions

As of October 2020, Wexner is vice-chair of the Board of Regents of the American College of Surgeons. Through this position he also serves as vice-chair of the executive committee of the Board of Regents, the vice-chair of the Finance Committee of the ACS, and the Regental Liaison to the ACS Board of Governors.
From 2011 to 2012, Wexner served as president of the American Society of Colon and Rectal Surgeons, for which he gave a Presidential Address in 2012. Prior to that, from 2010 to 2011 he served as president of the American Board of Colon and Rectal Surgery. He also served as president of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) from 2006 to 2007. In 2007 he delivered the SAGES Presidential Address entitled "Trials and tribulations in the history of surgical innovation."
Additionally, Wexner served on the Board of Regents of the American College of Surgeons from 2012 to 2021. Within this organization he is on the executive committee for the Commission on Cancer. He is also the chair of the National Accreditation Program for Rectal Cancer and was reappointed in 2023.
Wexner has served as the president of other professional organizations, including the American Society of Colon and Rectal Surgeons Research Foundation, the Florida Gastroenterologic Society, and South Florida Chapter of the American College of Surgeons. In addition to being licensed in the United States, Wexner is licensed in the United Kingdom with the General Medical Council and he is listed as a colorectal surgeon on the specialist register.
In 2024, Wexner was named as an Honorary Fellow for The Society of Black Academic Surgeons.

## Publications

Wexner is the co-editor-in-chief of Surgery. He has served on the editorial team for over 25 textbooks and has published 250 textbook chapters. He is a reviewer for 31 journals and is on 33 editorial boards. Wexner has authored numerous articles over his career.
In 2019, the Journal of Coloproctology published an analysis of the top 100 cited papers in benign anorectal disease which listed Wexner as the second most cited author. His paper with Marcio Jorge, Jorge, Marcio J. N.; Wexner, Steven D. (1993). "Etiology and Management of Fecal Incontinence". Diseases of the Colon & Rectum. 36 (1): 77–97. doi:10.1007/BF02050307. PMID 8416784. S2CID 37223486. was ranked as the most cited paper on benign anorectal disease.
On October 19, 2021, Elsevier published a list of the top cited scientists from 198 different fields and sub-fields based on the Scopus database. In the field of surgery, Wexner was ranked as the 34th most cited author of all time. In the field of colorectal surgery, Wexner is the 3rd most cited author of all time and the most cited living colorectal surgery author. As of September 2022, Dr. Wexner remained the most cited actively practicing colorectal surgery author in the world and the 21st most cited actively practicing surgeon in any specialty in the world. As of May 2024, his H Index is 117 and he has authored 974 peer-reviewed publications.
In his capacity as Regent for the American College of Surgeons, Wexner has also conducted a series of interviews with other surgeons from around the world called A Surgeon's Voice. The interviews focus on these surgeons' experiences with the COVID-19 pandemic and their unique perspectives as medical professionals. He has produced over 100 videos which have received over 300,000 views, as of May 2020. This series includes an interview with Johnson & Johnson CEO, Alex Gorsky, on the process of developing their COVID-19 vaccine.
Wexner also published studies which resulted in the eponymous Wexner Incontinence Score and the Wexner Constipation Score, as well as the Pilarsky Wexner Perianal Crohn's Score:
* Wexner, Steven D.; Marcio, Jorge (January 1993). "Etiology and Management of Fecal Incontinence". Diseases of the Colon and Rectum. 36 (1): 77–97. doi:10.1007/BF02050307. PMID 8416784. S2CID 37223486.
* Wexner, Steven D.; Agachan, Feran; Chen, Teng; Pfeifer, Johann; Reissman, Petachia (June 1996). "A constipation scoring system to simplify evaluation and management of constipated patients". Diseases of the Colon and Rectum. 39 (6): 681–685. doi:10.1007/BF02056950. PMID 8646957. S2CID 10924994.
* Wexner, Steven D.; Pikarsky, Alon J.; Gervas, Pascal (July 2002). "Perianal Crohn Disease: A New Scoring System to Evaluate and Predict Outcome of Surgical Intervention". Archives of Surgery. 137 (7): 774–777. doi:10.1001/archsurg.137.7.774. PMID 12093328.

### Selected books

* S.R. Steele, J.A. Maykel, S.D. Wexner (Eds.), (2020). Clinical Decision Making in Colorectal Surgery, 2nd ed. Springer Nature Switzerland. ISBN 978-3-319-65942-8
* David E. Beck (Author), Steven D. Wexner (Author), Janice F. Rafferty (Author) (2019). Gordon and Nivatvongs' Principles and Practice of Surgery for the Colon, Rectum, and Anus, 4th ed. Thieme. ISBN 1626234299
* David E. Beck, Scott R. Steele, Steven D. Wexner (2019). Fundamentals of Anorectal Surgery, 3rd ed. Springer Nature Switzerland. ISBN 3319659650
* Steven D. Wexner (Author), James W. Fleshman (Author) (2019). Colon and Rectal Surgery: Abdominal Operations (Master Techniques in Surgery), 2nd ed. Wolters Kluwer. ISBN 1496347234
* Steven D. Wexner (Author), James W. Fleshman (Author) (2019). Colon and Rectal Surgery: Anorectal Operations (Master Techniques in Surgery), 2nd ed. Wolters Kluwer. ISBN 1496348575
* David E. Beck, Steven D. Wexner, et al. (2014). The ASCRS Manual of Colon and Rectal Surgery, 2nd ed. Springer New York.
* Andrew P. Zbar, Robert D. Madoff, Steven D. Wexner (2013). Reconstructive Surgery of the Rectum, Anus and Perineum. Springer. ISBN 1848824122
* Steven D. Wexner, Andrew P. Zbar, Mario Pescatori (2010). Complex Anorectal Disorders: Investigation and Management. Springer. ISBN 1849968969
* Andrew P. Zbar, Steven D. Wexner (2010). Coloproctology (Springer Specialist Surgery Series). Springer. ISBN 1848827555
* N. Stollman, Steven D. Wexner (2007). Disease of the Colon, 1st ed. Informa Healthcare. ISBN 0824729994
* Steven D. Wexner, Graeme S. Duthrie (2006). Constipation: Etiology, Evaluation and Management. Springer. ISBN 1849968969
* G. Davila, G. Ghoneim G, Steven D. Wexner (2006). Pelvic Floor Dysfunction, 1st ed. Springer. ISBN 1852337303
* Steven D. Wexner et al. (2006). Diverticular Disease: Emerging Evidence in Common Conditions, 1st ed. Springer. ISBN 1849968969
* Steven D. Wexner, Andrew P. Zbar, Mario Pescatori (2005). Complex Anorectal Disorders. Investigation and Management, 1st ed. Springer. ISBN 185233-6900
* Steven D. Wexner (Section Ed.), B. MacFadyen (Section Ed.) (2004). Laparoscopic Surgery of the Abdomen. Springer-Verlag. ISBN 978-0-387-98468-1
* P. Boulos, Steven D. Wexner (2000). Current Challenges in Colorectal Surgery, 1st ed. W. B. Saunders. ISBN 0-7020-2559-3
* Steven D. Wexner, (1999). Protocols in General Surgery: Laparoscopic Colorectal Surgery. ISBN 0471240303

### Selected articles

As noted above, Wexner has published a myriad of articles in scientific journals and books, including over 780 manuscripts and 26 editorials or commentaries in the last twenty years. Most recently, he co-authored the following noteworthy articles on COVID, on the contributions of women to the field of colorectal surgery, and on racial disparities in colorectal surgery outcomes:
* Wexner, Steven D.; Nelson, Heidi; Stain, Steven C.; Turner, Patricia L.; Cortés-Guiral, Delia (September 2020). "The American College of Surgeons Response to the COVID-19 Pandemic (Part I): Cancer Care, COVID-19 Registry, Surgeon Wellness". The American Surgeon. 86 (7): 751–756. doi:10.1177/0003134820940771. PMID 32916067.
* Wexner, Steven D.; Opelka, Frank; Bailey, Patrick V.; Cortés-Guiral, Deila (September 2020). "The American College of Surgeons Response to the COVID-19 Pandemic (Part II): Advocacy and Public Policy". The American Surgeon. 86 (7): 757–761. doi:10.1177/0003134820936614. PMID 32916074. S2CID 221636992.
* Wexner, Steven D.; Hoyt, David B.; Cortes-Guiral, Delia (September 2020). "The American College of Surgeons Response to the COVID-19 Pandemic (Part III): Leadership in a Time of Crisis". The American Surgeon. 86 (7): 762–765. doi:10.1177/0003134820940772. PMID 32916069. S2CID 221636398.
* Keller, Deborah S.; Berho, Mariana; Brown, Gina; Hull, Tracy; Moeslein, Gabriela; Wexner, Steven D. (July 2020). "A narrative celebrating the recent contributions of women to colorectal surgery". Surgery. 168 (3): 355–362. doi:10.1016/j.surg.2020.06.024. PMID 32741622. S2CID 220942775.
* Qing, S.H.; Rao, K.Y.; Jiang, H.Y.; Wexner, S.D. (April 2003). "Racial differences in the anatomical distribution of colorectal cancer: a study of differences between American and Chinese patients". World Journal of Gastroenterology. 9 (4): 721–725. doi:10.3748/wjg.v9.i4.721. PMC 4611437. PMID 12679919.
* Sharp, S.P.; Ata, A.; Chismark, A.D.; Wexner, S.D. (June 2020). "Racial disparities after stoma construction in colorectal surgery". Colorectal Disease. 22 (6): 713–722. doi:10.1111/codi.14943. PMID 31876362. S2CID 209482820.
In addition to the articles above, some of Dr. Wexner's more recent articles are listed below:
* Emile, SH; Horesh, N; Wexner, SD (May 2023). "Reporting of Immunotherapy and Biologic Therapy in the National Cancer Database-Reply". JAMA Oncology. 9 (7): 1003–1004. doi:10.1001/jamaoncol.2023.0784. PMID 37140915. S2CID 258484897.
* Emile, SH; Horesh, N; Garoufalia, Z; Gefen, R; Zhou, P; Strassman, V; Wexner, SD (April 2023). "Robotic and laparoscopic colectomy: propensity score-matched outcomes from a national cancer database". British Journal of Surgery. 110 (6): 717–726. doi:10.1093/bjs/znad096. PMID 37075480.
* Emile, SH; Garoufalia, Z; Barsom, S; Horesh, N; Gefen, R; Zhou, P; Wexner, SD (April 2023). "Systematic review and meta-analysis of randomized clinical trials on the treatment of low anterior resection syndrome". Surgery. 173 (6): 1352–1358. doi:10.1016/j.surg.2023.02.010. PMID 37012144. S2CID 257905660.
* Freund, M; Horesh, N; Emile, SH; Garoufalia, Z; Gefen, R; Wexner, SD (March 2023). "Predictors and outcomes of positive surgical margins after local excision of clinical T1 rectal cancer: A National Cancer Database analysis". Surgery. 173 (6): 1359–1366. doi:10.1016/j.surg.2023.02.012. PMID 36959073. S2CID 257680731.
* Freund, M; Emile, SH; Horesh, N; Gefen, R; Wexner, SD (March 2023). "The importance of surgical resection in the management of rectal sarcoma: A national cancer database analysis of 133 cases". European Journal of Oncology. 49 (3): 647–654. doi:10.1016/j.ejso.2022.10.014. PMID 36756950. S2CID 253058786.
* Emile, SH; Horesh, N; Freund, M; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Wexner, SD (January 2023). "Treatment and outcome trends and predictors of overall survival of rectal melanoma: Analysis of the National Cancer Database". European Journal of Oncology. 49 (7): 1275–1282. doi:10.1016/j.ejso.2023.01.021. PMID 36732208. S2CID 256301182.
* Emile, SH; Horesh, N; Freund, M; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Maron, D; DaSilva, G; Wexner, SD (March 2023). "Trends in the Characteristics, Treatment, and Outcomes of Rectal Adenocarcinoma in the US From 2004 to 2019: A National Cancer Database Analysis". JAMA Oncology. 9 (3): 355–364. doi:10.1001/jamaoncol.2022.6116. PMC 10020883. PMID 36580307.
* Emile, SH; Horesh, N; Freund, M; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Wexner, SD (February 2023). "A National Cancer Database analysis of the predictors of unplanned 30-day readmission after proctectomy for rectal adenocarcinoma: The CCF RETURN-30 Score". Surgery. 173 (2): 342–349. doi:10.1016/j.surg.2022.10.034. PMID 36473745. S2CID 254348327.
* Emile, SH; Horesh, N; Freund, M; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Dasilva, G; Wexner, SD (January 2023). "Outcomes of laparoscopic versus robotic-assisted resection of T4 rectal cancer: propensity score-matched analysis of a national cancer database". British Journal of Surgery. 110 (2): 242–250. doi:10.1093/bjs/znac396. PMID 36471483.
* Dip, F; Lo Menzo, E; Bouvet, M; Schols, RM; Sherwinter, D; Wexner, SD; White, KP; Rosenthal, RJ (December 2022). "Intraoperative fluorescence imaging in different surgical fields: Consensus among 140 intercontinental experts". Surgery. 172 (6S): S54 – S59. doi:10.1016/j.surg.2022.07.025. PMID 36427931. S2CID 253827695.
* Dip, F; Lo Menzo, E; Bouvet, M; Schols, RM; Sherwinter, D; Wexner, SD; White, KP; Rosenthal, RJ (December 2022). "Intraoperative fluorescence imaging in different surgical fields: First step to consensus guidelines". Surgery. 172 (6S): S3 – S5. doi:10.1016/j.surg.2022.04.017. PMID 36427928. S2CID 253833292.
* Freund, M; Emile, SH; Horesh, N; Garoufalia, Z; Gefen, R; Perets, M; Wexner, SD (December 2022). "Redo ileocolic resection for recurrent Crohn's disease: A review and meta-analysis of surgical outcomes". Surgery. 172 (6): 1614–1621. doi:10.1016/j.surg.2022.09.003. PMID 36270822. S2CID 253037408.
* Emile, SH; Silva-Alvarenga, E; Horesh, N; Freund, M; Garoufalia, Z; Wexner, SD (February 2023). "Concordance between clinical and pathologic assessment of T and N stages of rectal adenocarcinoma patients who underwent surgery without neoadjuvant therapy: A National Cancer Database analysis". European Journal of Surgical Oncology. 49 (2): 426–432. doi:10.1016/j.ejso.2022.09.014. PMID 36257901. S2CID 252676451.
* Emile, SH; Freund, M; Horesh, N; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Wexner, SD (February 2023). "Risk factors and predictors of 30-day complications and conversion to open surgery after repeat ileocolic resection of Crohn's disease". Surgical Endoscopy. 37 (2): 941–949. doi:10.1007/s00464-022-09557-4. PMID 36068385. S2CID 252092903.
* Emile, SH; Horesh, N; Freund, M; Parlade, A; Nagarajan, A; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Dasilva, G; Wexner, SD (October 2022). "Assessment of mesorectal fascia status in MRI compared with circumferential resection margin after total mesorectal excision and predictors of involved margins". Surgery. 172 (4): 1085–1092. doi:10.1016/j.surg.2022.06.005. PMID 35970606. S2CID 251557312.

## AIS Channel

Wexner is a contributor for the AIS (Advances in Surgery) Channel, a leading global educational platform providing training and networking for surgeons. Since 2014, AIS has provided audiovisual recordings and broadcasts of procedures, techniques, and new developments in the world of surgery. AIS works with a constantly growing network of hospitals and key opinion leaders and validating academic and scientific societies. Wexner has been involved in dozens of broadcasts with topics ranging from robotic colorectal surgery teaching techniques to discussing diversity, equity, and inclusion issues in healthcare.

## Personal life

Wexner's father was Judge Ira Wexner, who presided in New York for over twenty years and lived part time in West Boca. Wexner's spouse, Mariana Berho, M.D., is Chief of Staff at Cleveland Clinic Weston and also serves on the Board of Governors and Board of Trustees at the parent organization, Cleveland Clinic.